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(Cushing's Disease; Hypercortisolism)
Cushing's syndrome is a hormone disorder. Cortisol, in normal doses, helps the body manage stress and infection. However, these high levels over a long period of time can cause several health problems.
Cushing's syndrome is caused by extended exposure to a hormone called cortisol. Prolonged or excess exposure to cortisol may be caused by:
- Long-term use of corticosteroid hormones such as cortisone or prednisone
Excess production of cortisol by:
- Tumor or abnormality of the adrenal gland.
Tumor or abnormality of the pituitary gland. In the case of a
it is called Cushing's disease
- Rarely, tumors of the lungs, thyroid, kidney, pancreas, or thymus gland.
|Pituitary and Adrenal Glands
|Copyright © Nucleus Medical Media, Inc.
Factors that may increase your chance of Cushing's syndrome include:
Cushing's syndrome may cause:
- Weight gain of the upper body and trunk
- Rounded face
- Severe fatigue or muscle weakness
- Easily bruised, thinner skin
- Purple stretch marks
- Excess hair growth or acne in women
Menstrual disorders, especially infrequent or
- Reduced fertility and interest in sex
- Personality changes or mood swings
You will be asked about your symptoms and medical history. A physical exam will be done. Tests may be done to determine the level of cortisol and find a cause.
Tests for cortisol levels may include:
- 24-hour urinary free cortisol level
- Late-evening cortisol saliva/blood level
- Dexamethasone suppression test
Tests to determine the cause of Cushing's Syndrome may include:
- Blood test for adrenocorticotropin hormone (ACTH) level
- High-dose dexamethasone suppression test
Other tests may help to see if there is a tumor on the pituitary or adrenal glands. Images may be taken with:
Treatment of Cushing's syndrome depends on the cause. Talk with your doctor about the best treatment plan for you. Options include:
- Surgical removal of tumor
- Surgical removal of part, all, or both adrenal glands
- Radiation therapy
for some persistent tumors
- Gradual withdrawal of cortisone-type drugs under close medical supervision
- Drugs that decrease cortisol production or block the functioning of other adrenal products
Work with your doctor to keep your use of corticosteroid drugs to a minimum.
Cushing's Support and Research Foundation http://www.CSRF.net
Family Doctor—American Academy of Family Physicians http://familydoctor.org
Health Canada http://www.hc-sc.gc.ca
The College of Family Physicians of Canada http://www.cfpc.ca
Arnaldi G, Angeli A, et al. Diagnosis and complications of Cushing’s syndrome: a consensus statement.
J Clin Endocrinolo Metabo. 2003;88:5593-5602.
Cushing disease. EBSCO DynaMed website. Available at:
. Updated February 21, 2014. Accessed February 27, 2014.
Cushing's syndrome. National Endocrine and Metabolic Diseases Information Service website. Available at:
http://endocrine.niddk.nih.gov/pubs/cushings/cushings.aspx. Updated April 6, 2012. Accessed February 27, 2014.
Diez JJ, Iglesias P. Pharmacological therapy of Cushing’s syndrome: drugs and indications.
Mini Rev Med Chem. 2007;7(5):467-480.
Kirk LF Jr, Hash RB, et al. Cushing's disease: clinical manifestations and diagnostic evaluation.
Am Fam Physician. 2000;62(5):1119-1127, 1133-1134.
Tritos NA, Biller BM, et al. Management of Cushing disease.
Nat Rev Endocrinol. 2011;7(5):279-289.
Makras P, Toloumis G, et al. The diagnosis and differential diagnosis of endogenous Cushing’s syndrome.